Drug delivery to the small intestine

Oral delivery of drugs to the small intestine is an important topic in the research and development of more effective oral dose forms. This review highlights several important developments in this area. An overriding theme in drug delivery to the small intestine is how to increase the efficiency (ie, how to increase bioavailability) of absorption. The role of P-glycoprotein and intestinal transporters is discussed in this regard. These systems are normally studied under defined in vitro conditions; recent data suggest that this approach, though useful, may not fully represent the in vivo situation. Recent advances and issues in the characterization and prediction of drug absorption from the small intestine are reviewed. These efforts, if successful, will shorten development timelines by eliminating compounds with poor absorption characteristics early in the process. Nanoparticulate delivery systems and those prepared by microfabrication technology are being used to improve bioavailability of poorly absorbed drugs. A relatively new technique (electroporation) has been proposed to enhance oral delivery of macromolecules, still an unrealized objective in drug delivery.

[1]  Gorka Orive,et al.  Drug delivery in biotechnology: present and future. , 2003, Current opinion in biotechnology.

[2]  M. Prausnitz,et al.  Electroporation-mediated delivery of molecules to model intestinal epithelia. , 2004, International journal of pharmaceutics.

[3]  J. Crison,et al.  A Theoretical Basis for a Biopharmaceutic Drug Classification: The Correlation of in Vitro Drug Product Dissolution and in Vivo Bioavailability , 1995, Pharmaceutical Research.

[4]  Y. Sugiyama,et al.  Quantitative Evaluation of the Function of Small Intestinal P-Glycoprotein: Comparative Studies Between in Situ and in Vitro , 2003, Pharmaceutical Research.

[5]  J. Irache,et al.  Bioadhesion of Lectin-Latex Conjugates to Rat Intestinal Mucosa , 1996, Pharmaceutical Research.

[6]  Antony D'Emanuele,et al.  The use of a dendrimer-propranolol prodrug to bypass efflux transporters and enhance oral bioavailability. , 2004, Journal of controlled release : official journal of the Controlled Release Society.

[7]  S. Sahoo,et al.  Nanotech approaches to drug delivery and imaging. , 2003, Drug discovery today.

[8]  D. Tomalia,et al.  Poly(amidoamine) (PAMAM) dendrimers: from biomimicry to drug delivery and biomedical applications. , 2001, Drug discovery today.

[9]  M. Wirth,et al.  Lectin-mediated bioadhesion: binding characteristics of plant lectins on the enterocyte-like cell lines Caco-2, HT-29 and HCT-8. , 1998, Journal of controlled release : official journal of the Controlled Release Society.

[10]  S. Frokjaer,et al.  Intestinal solute carriers: an overview of trends and strategies for improving oral drug absorption. , 2004, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[11]  O. Baffa,et al.  Disintegration of magnetic tablets in human stomach evaluated by alternate current biosusceptometry. , 2003, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[12]  Mehran Yazdanian,et al.  The “High Solubility” Definition of the Current FDA Guidance on Biopharmaceutical Classification System May Be Too Strict for Acidic Drugs , 2004, Pharmaceutical Research.

[13]  M. Jaroszeski,et al.  Clinical applications of electrochemotherapy. , 1999, Advanced drug delivery reviews.

[14]  G. Amidon,et al.  Human Jejunal Permeability of Cyclosporin A: Influence of Surfactants on P-Glycoprotein Efflux in Caco-2 Cells , 2003, Pharmaceutical Research.

[15]  David V. Prior,et al.  Remote controlled capsules in human drug absorption (HDA) studies. , 2003, Critical reviews in therapeutic drug carrier systems.

[16]  D. Keppler,et al.  Export pumps for anionic conjugates encoded by MRP genes. , 1999, Advances in enzyme regulation.

[17]  K. Thummel,et al.  In vitro and in vivo drug interactions involving human CYP3A. , 1998, Annual review of pharmacology and toxicology.

[18]  Y. Kato,et al.  Influence of Drugs and Nutrients on Transporter Gene Expression Levels in Caco-2 and LS180 Intestinal Epithelial Cell Lines , 2003, Pharmaceutical Research.

[19]  M. A. Arangoa,et al.  Nanoparticles with specific bioadhesive properties to circumvent the pre-systemic degradation of fluorinated pyrimidines. , 2004, Journal of controlled release : official journal of the Controlled Release Society.

[20]  S. Frokjaer,et al.  Prodrugs of purine and pyrimidine analogues for the intestinal di/tri-peptide transporter PepT1: affinity for hPepT1 in Caco-2 cells, drug release in aqueous media and in vitro metabolism. , 2003, Journal of controlled release : official journal of the Controlled Release Society.

[21]  Joe Palandra,et al.  Predicting Oral Absorption of Drugs: A Case Study with a Novel Class of Antimicrobial Agents , 2003, Pharmaceutical Research.

[22]  P. Watkins Drug metabolism by cytochromes P450 in the liver and small bowel. , 1992, Gastroenterology clinics of North America.

[23]  H. Saito,et al.  Inhibitory Effect of Zinc on PEPT1-Mediated Transport of Glycylsarcosine and β-Lactam Antibiotics in Human Intestinal Cell Line Caco-2 , 2003, Pharmaceutical Research.

[24]  B. Hirst,et al.  The ABCs of drug transport in intestine and liver: efflux proteins limiting drug absorption and bioavailability. , 2004, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[25]  H. Ghandehari,et al.  Transport mechanism(s) of poly (amidoamine) dendrimers across Caco-2 cell monolayers. , 2003, International journal of pharmaceutics.

[26]  Panos Macheras,et al.  Quantitative Biopharmaceutics Classification System: The Central Role of Dose/Solubility Ratio , 2003, Pharmaceutical Research.

[27]  Mark M. Roden,et al.  Interrelationship Between Substrates and Inhibitors of Human CYP3A and P-Glycoprotein , 1999, Pharmaceutical Research.

[28]  R. Pandey,et al.  Nanoparticle encapsulated antitubercular drugs as a potential oral drug delivery system against murine tuberculosis. , 2003, Tuberculosis.

[29]  T. Desai,et al.  Bioadhesive microdevices with multiple reservoirs: a new platform for oral drug delivery. , 2002, Journal of controlled release : official journal of the Controlled Release Society.

[30]  R. Houghten,et al.  Toward Targeted Oral Vaccine Delivery Systems: Selection of Lectin Mimetics from Combinatorial Libraries , 2003, Pharmaceutical Research.

[31]  R. Walgren,et al.  Efflux of dietary flavonoid quercetin 4'-beta-glucoside across human intestinal Caco-2 cell monolayers by apical multidrug resistance-associated protein-2. , 2000, The Journal of pharmacology and experimental therapeutics.

[32]  Joseph V. Turner,et al.  Bioavailability Prediction Based on Molecular Structure for a Diverse Series of Drugs , 2004, Pharmaceutical Research.

[33]  D. Thakker,et al.  Efflux Ratio Cannot Assess P-Glycoprotein-Mediated Attenuation of Absorptive Transport: Asymmetric Effect of P-Glycoprotein on Absorptive and Secretory Transport Across Caco-2 Cell Monolayers , 2003, Pharmaceutical Research.

[34]  T. Desai,et al.  Microfabricated drug delivery systems: from particles to pores. , 2003, Advanced drug delivery reviews.

[35]  M. Paine,et al.  P-Glycoprotein Increases from Proximal to Distal Regions of Human Small Intestine , 2003, Pharmaceutical Research.

[36]  F. Lammert,et al.  P-Glycoprotein Attenuating Effect of Human Intestinal Fluid , 2003, Pharmaceutical Research.

[37]  T. Desai,et al.  Bioadhesive poly(methyl methacrylate) microdevices for controlled drug delivery. , 2003, Journal of controlled release : official journal of the Controlled Release Society.

[38]  W. Schmitt,et al.  A Physiologic Model for Simulating Gastrointestinal Flow and Drug Absorption in Rats , 2003, Pharmaceutical Research.

[39]  M. Garcia‐Fuentes,et al.  Design of lipid nanoparticles for the oral delivery of hydrophilic macromolecules , 2003 .